A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:
1. Widespread pain index (WPI) > 7 and symptom severity > 5 or WPI 3-6 and SS scale score > 9
2. Symptoms have been present at a similar level for at least 3 months.
3. The patient does not have a disorder that would otherwise explain the pain.
ASCERTAINMENT
1. WPI: note the number areas in which the patient has had pain over the last week. In how many areas has the patient had pain? Score will be between 0 and 19.
Shoulder girdle,
left Shoulder girdle,
right Upper arm,
left Upper arm,
right Lower arm,
left Lower arm,
right Hip (buttock, trochanter),
left Hip (buttock, trochanter),
right Upper leg,
left Upper leg,
right Lower leg,
left Lower leg,
right Jaw,
left Jaw,
right Chest
Abdomen
Upper back
Lower back
Neck
2.
SS scale score:
Fatigue
Waking unrefreshed
Cognitive symptoms
For the each of the 3 symptoms above, indicate the level of severity over the past week using the following scale:
0 = no problem
1 = slight or mild problems, generally mild or intermittent
2 = moderate, considerable problems, often present and/or at a moderate level
3 = severe: pervasive, continuous, life-disturbing problems
Considering somatic symptoms in general, indicate whether the patient has:*
0 = no symptoms
1 = few symptoms
2 = a moderate number of symptoms
3 = a great deal of symptoms
The SS scale score is the sum of the severity of the 3 symptoms (fatigue, waking unrefreshed, cognitive symptoms) plus the extent (severity) of somatic symptoms in general. The final score is between 0 and 12.
* Somatic symptoms that might be considered: muscle pain, irritable bowel syndrome, fatigue/tiredness, thinking or remembering problem, muscle weakness, headache, pain/cramps in the abdomen, numbness/tingling, dizziness, insomnia, depression, constipation, pain in the upper abdomen, nausea, nervousness, chest pain, blurred vision, fever, diarrhea, dry mouth, itching, wheezing, Raynaud's phenomenon, hives/welts, ringing in ears, vomiting, heartburn, oral ulcers, loss of/change in taste, seizures, dry eyes, shortness of breath, loss of appetite, rash, sun sensitivity.
Read the complete article (in pdf) from the American College of Rheumatology.
Interesting. I am not very up to date and thought it - fibro- was still diagnosed on tender points as that was what happened to me many years ago.
ReplyDeleteYes Leanne in 2010, the American College of Rheumatology endorsed a new set of criteria for diagnosing fibromyalgia. There have been comparison tests done I think and the new criteria works better
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